Dr. Rodolfo Gari Talks About Pain After Surgery And The Best Treatments

Interviewer: If we’re in pain and we get surgery, we expect that to fix the problem, right? Well, sometimes it doesn’t. Dr. Rudy Gari from Florida Pain Relief Group is here to help us figure out what to do next. Welcome back, Dr. Gari.

Dr. Gari: My pleasure.

Interviewer: How often do you have people come through your door and say I’ve had back surgery?

Dr. Gari: Everyday.

Interviewer: Everyday, and some people say they’ve had more than one?

Dr. Gari: I’ve had patients have one, two, three…I’ve had one patient that’s had five back operations.

Interviewer: And are they just at their wit’s end because it’s not helping?

Dr. Gari: Unfortunately. But we actually take a lot of pride in the fact that our specialty pain management, it’s the end of the road, but it’s a nice road to be in because there’s a lot of things that we can do for you. There’s a large majority of the back operations that do very, very well for patients, and the majority of patients do well from back surgery. But there is that select few that it doesn’t do well. And so for example the chances of a successful operation after the first back surgery is somewhere between 70% and 80 plus %.

Interviewer: You’re odds are pretty good.

Dr. Gari: Very good. Second one, maybe 40% to 50%. And the third one you’re dropping down to 15% to 20%.

Interviewer: So more surgery is not an option at this point.

Dr. Gari: It’s not an option because a lot of times by the time you’ve had three back operations, in the majority of situations you should be talking to a physician like myself that specializes in pain management because by that point, unfortunately your pain has pretty much become your illness. So we can find lots of ways to help you without another back operation.

Interviewer: What do you do when somebody comes to you and says I’ve had four operations? Do you get an X-ray to see what’s been done or how do you assess the damage?

Dr. Gari: The first thing I do is to listen very carefully, so we’re gonna get a thorough history. I want to know everything that’s happened. Why did you get the first back operation? Second, third, etc. Second thing I’m gonna do is I’m going to examine that patient. Find out where the pain is and where it’s coming from. A lot of times you can pick up a lot on the examination. For example, I had a patient just a couple of days ago who came in and said he had pain in his elbow. They told him he had tennis elbow. What he really had was a pinched nerve in his neck causing that. So you have to do an examination. I picked it up because he had weakness, loss of sensation, there’s a lot of things you can pick up in the examination. The third thing that I’m gonna do is maybe an X-ray, maybe an MRI, maybe a cat scan, different studies. I want to know exactly where you are after your operations. Once we’ve come across all that we’ll establish a diagnosis and establish a treatment plan, what to do. And over 90% does not involve another back operation.

Interviewer: Isn’t that great? And what percentage involves pills? There are different ways to treat it.

Dr. Gari: Well some patients are gonna need pills, and that could be an anti-inflammatory, it could be a muscle relaxer, it could be an opioid, it could be an anti-depressant, just different things. But we want to minimize your pills. Nerve blocks or sometimes things that are called [inaudible 00:03:09] re-stimulators, which are just little tiny electrodes that we can place in your back to actually take away that pain sensation in your back and your legs and replace it with a much more gentle and much more comfortable sensation.

Interviewer: So basically you give them their freedom back?

Dr. Gari: That’s what we try to do with every patient.

Interviewer: So instead of going for the operation first and foremost, go see Dr. Gari first to see if you even need it in the first place.

Dr. Gari: Absolutely. And we will gladly refer you to a neurosurgeon or a surgeon if we need that or if you want a second opinion.

Interviewer: Okay. Dr. Gari, thank you very much. You can visit their website, floridapainreliefgroup.com to schedule your same-day appointment. Give them a call at 844-KICK-PAIN. We’ll be right back with more Daytime so don’t go away.

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ABOUT THE AUTHOR

Rodolfo Gari, MD

Rodolfo Gari, M.D., MBA, founded Physician Partners of America in 2013 after practicing medicine and seeking a healthcare system that benefits both patients and doctors. He practiced as both an anesthesiologist and pain management physician in Tampa before founding his own pain management practice, Tampa Pain Relief Center. In 1999, he built his own surgery center to practice interventional main management in a way that benefited both physicians and their patients. He went on to found Surgery Partners, Tampa Pain Relief Center and Anesthesiology Professional Services, a group of medical practices with multiple offices throughout Florida. After selling the business, Dr. Gari created Texas Pain Relief Group, the first affiliate of Physician partners of America. The company has grown from a single clinic to nearly 30, and from three employees to more than 500.

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